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Healthcare Management Midterm

Terms in this set (130)

What was not a key strategy for successful healthcare organizations in the past?
Attracting talented physcians
Reducing costs
Adding New technology
Finding new methods of increasing revenue
Reducing Costs
The Institute of Medicine's Crossing the Quality Chasm report features which of the following healthcare aims?
Safe, Timely, Equitable
Which strategy is not considered part of the evidence based medicine?
Correct coding of procedures and diagnoses
Using patient care guidelines
Using computerized medical records to identify optimal appraoches to care
Using shared decision making between patients and providres regarding surgerys
Correct coding of procedures and diagnoses
When the Institute of Medicine recommends transparency it means
Making information on safety, evidence-based practice, and patient satisfaction available to patients and their families
Why is it useful for the patient to be at the center of the healthcare microsystem?
Using systems think is the only way to optimize the healthcare system
Reinforcing feedback prompts change that build on itself and amplifies the process. True of False
True
An example of balancing feedback is
Using a cardiac monitor
System thinking in healthcare will
optimize quality, safety, access, and cost
The goal of operations management is to
produce and deliver the organizations products and services more effectively and efficiently
Which goal cannot be reached without operations management techniques?
Controlling costs
Improving level of service
Improving quality
Develpong new clinical treatments
Developing new clinical treatments
Which part of a system controls quality
Feedback
Which level of knowledge hierarchy is most useful for making management decisions?
Wisdom
What element of a system is necessary for mass production?
Specialization of tasks
Which is not one of Frederick Taylor's principles of scientific management?
Employee work experience
Frank and Lillian Gilbreth used which scientific management technique to raise their children?
They bought only one type of sock for all their children, thereby avoiding the need for sorting
Which of the following is not a key project management tool?
Gantt Chart
Program evaluation and review technique
Quality circle
Critical path method
Quality ciricles
What is the most important message from Deming's work?
Improving quality will reduce expenses while increasing productivity and market share
The term Six Sigma refers to
3.4 defects per million opportunities
Which of the following is not a quality certification award?
ISO 9000
Conventry Award
Joint commission
Baldrige Award
Conventry Award
The just in time inventory system and Toyota production system were the foundation of
Lean production
Supply chain management ecompasses the planning and management of all activities involed in sourcing and procurement, conversion, and logistics. True or false
True
The clincial delivery of healthcare is standardized throughout the US. true or false
False
Which of the following is not a part of evidence based medicine?
Medical research
Clinical protocols
Total Quality Management groups
Effective dissemination and implementation
Total quality mangement groups
Evidence based medicine has not been widely used because of
dosagreement over science
perception that is a threat to professional automonomy
resistsance to change
The best example of standard care is
a minute clinic
The best example of custom care is
type II diabetes care
Prevention quality indiciators are used
to identify hospital admissions that could be prevented with more effective ambulatory care
The accountable care organization in the ACA was based on which demonstration project?
Physicians group practice
Which of the folloiwng is not a key element of the treatment of patients with chronic disease?
Population based outreach
The use of generic drugs where possible
Evidence based medicine with automated clinical decision suport
team care healthcare home
The use of generic drugs where possible
The primary function of the healthcare home is to serve as
an organized team of caregivers who focus on patients with chronic disease
Comparative effectiveness research is used to
assess the quality and relevance of treatments for common conditions
Public reporting of healthcare quality does not measure
Patient compliance
Which public reporting strategy is most effective at improving quality?
Rewarding providers who have high scores or improvements
What is not a goal of pay for performance?
To encourage poor providers to leave the system
What is not a method used in pay for performance systems
Payment for high levels of ancillary (lab and imaging) use
which of the following is the definition of clinical decision support?
Guidelines and prompts built into electronic health records
The primary purpose of the balanced scorecard is
to effectively implement strategy
What is the most improtant tool used to implement a traditional strategic plan?
Management control and actions
What is the primary problem with using traditional reporting tools to execute strategy?
Reports do not connect to other reports or actions
What does balance mean in the term balance scorecarddd
An organization executes strategy by viewing itself from a set of balanced perspectives
What is not a key feature of the balance scorecard management system?
Provide an evaluation system for employee performance
What are the four perspectives used in the balance scorecard?
Finance, operations, customers, employees
Which is the most effective financial strategy for a healthcare organization today?
Reduce costs and improve productivity
From the customer perspective, what is the most important question an organization should ask
What is the value proposition we are delivering to our customers
Which od these measures is not used in the customer perspective?
Number of new products introduced
Customer retention
Customer acquisition
Customer satisfaction
Number of new products introduced
Once a product has been designed and delivered, what is the last step in an effective organization's operational process?
Post sales service
What is not a measure of innovation?
Percentage of sales from new products
New product introductions
Product profitibilitu
Time to breakeven
Product profitability
What is the ultimate goal of providing employees with training, a supportive culture, and appropriate IT tools?
Meeting organization goals
What is not a measure of employee satisfaction?
Involvement in decision
Recognition for doing a good job
Minimal number of requests for salary increase
Active encouragement of creativity and innovation
Minimal number of requests for salary increase
The purpose of a strategy map is to
link strategic initiatives with if then arrows
The metrics on the balanced scorecard are used to
display current performance and predict future results
The topmost perspective on the standard strategy map is
Financial
Once a strategy map has been constructed, which of the following action si snot critical to the effective use of the balanced scorecard?
Set stretch targets for all initiatives on the map
Identify critical cross organization initiatives that support the strategy map
Link the map to annual resource allocation and budgets
Use a variety of graphic to display monthly results
Use a variety of graphics to display monthly resutls
A data warehouse is
storage for back up data
Project Management Institute formal project management is
evidence-based procedures for delivering desired results on time and within budget
The Project Management Institute is
the intellectual and academic home of the project management profession
Which item is not a characteristic of a project?
It is done on time
It has a specified scope of work
It has a specified budget
It produces cost savings
it produces cost savings
What must be included in at least four of the steps for creating a project plan?
Involving stakeholder
The best method of selecting among competing projects is
Develop a matrix of important criteria, and then rank each project
The scope of a project is defined by its
cost, time, and performance
A project has been chartered and now needs to be done more quickly bt at the same performance level. What effect will this change have?
The cost will increase
The project champion is
a senior manager who can help solve high level problems as the project progresses
Why it is important to have project milestones?
They show the expected times for the major accomplishments in a project
The duration of each task in a work breakdown should be no more than
three weeks
The most detailed level in a work breakdown is
work package
a RASIC diagram is used to
identify the role and responsibility of each team member for each task
Which of the following is the most important feature of a network digram
It links tasks in a predecessor relationship
The critical path is used to
determine the shortest possible duration for a project
A project can be crashed by
shortening the duration of tasks on a the critical path
Earned value analysis can be used to determine if a project is
under budget and ahead of schedule
A change control policy is important because
no project is ever completed exactly as it was initially planned
Which type of contracting poses the highest risk?
Time and materials
Agile project management should be used when
the exact performance characteristics are unknown at the beginning of the project
Which is not a good meeting behavior as a member of a project team?
Challenge poor ideas
Janice has a problem with her accounts receivable system. She has framed the problem as slow payments from Medicare. Her next step should be to
Generate or determine possible courses of action and evaluate these alternatives
Janice's solution for improving her Medicare accounts receivable system does not perform as expected. Janice's team had applied system changes that htey had copied from their Medicaid billing system. This type of failure is known as
Shortsighted shortcuts
Processing mapping is
a graphical depiction of a process showing inputs, outputs, and steps
used to understand and optimize process
an integral part of most improvement initiatives, including six sigma, lean, balanced scoreboard, root-cause analysis, and failure mode and effects analysis
Janice has decided she wants to take a more detailed look at her Medicare billing process and asks her team to create a process map. The team's first step would be to
determine process and boundaries and desired level of detail
A diamond is used in process map to
show points in the process where alternative paths can be followed
Swim lane mapping is used to
identify tasks that are beign completed by each individual or department in a process
Janice keeps finding errors in her Medicare billing process. Which root-cause tool would not be useful for improving the system
Employee engagement survery
As Janice observes all the steps in her Medicare billing process, she notes that she has only one staff member who is doing coding reviews and that individual is always behind. She decides to add a staff member to also do coding reviews. What has Janice just done?
Identified and elevated the constraint
Which of the following elements is not necessary to use optimization tools such as linear programming?
a process map connecting elements that are affected by the decision
An objective function the quantity that needs to be minimized or maximized
The controllable inputs or decision variabls that affect the value of the objective function
Constraints that limit that values that the decision variables can take
A process map connecting elements that are affected by the decision
In general, a decision tree is used for
examining and evaluating decisions in a structured manner
Janice has decided to make significant changes to her Medicare billing process. She employs force field analysis to help her determine if these changes can be implemented successfully. Which two factors has she considered in this analysis?
Driving forces and restratining forces
When investigators start to collect data for a project, what is the first question they need to ask?
Why is the data needed?
A data collection method is considered reliable if
it provides the same result if the measurement is repeated
A pareto diagram is
a histogram that is sorted by the length of the bars
A scatter plot is
a graphical display of relationship between two variables
Which of the following is not a measure of central tendency?
Mean
Range
Median
Mode
Range
Which of the following is not a measure of variability?
Mean absolute variation
Variance
Standard deviation
Process capability
Process capability
A data point is an outlier in a bell shaped distribution if
It is greater than three standard deviations above the mean
Ivan is the IT director at Memorial Hospital. He conducts an experiment to determine the error rate for data entry of diagnostic codes. e notes that five errors were mad for every 100 entries. The observed probability of error is
5%
Bayes theorem is used to
revise the calculation of conditional probability as new information about the situation is obtained
The central limit states that
a sample taken from any distribution will have a normal distribution
To find the confidence intervals from small samples (n<30) you need to use a
t distribution
A type I error in hypothesis testing is
the probability of rejecting the null hypothesis when it is true
Which is not a principle assumption about linear regression?
There is no autocorrelation in the sample
Jose is the supervisor of a laboratory. One of his testing machines seems to be producing different results for the same sample. To make sure he is delivering correct results, Jose uses a second machine to check the results of the first. This type of quality failure is knonwn as
Appraisal
ISO 9000 is
a system of international standards concerned with ensuring that organizations maintain consistently high levels of quality
Which category of performance is not part of the Baldrige Award
Financial performance
The term Six Sigma represents a goal of
3.4 defects per million opportunitie
Jose wants to improve quality in his laboratory with Six Sigma program. He wants Sandy, his chemistry supervisor, to attend a Six Sigma training program so that she can oversee all Six Sigma projects that will occur in the lab. Sandy will be trained as a
Black belt
What is the correct project cycle for a Six Sigma project
Define, Measure, Analyze, Improve, Control
Which tool is not used for Six Sigma projects?
Fishbone diagram
Balance sheet
Pareto Chart
Scatter Diagram
Balance sheet
Which variables are measured in the measurement phase of Six Sigma project?
Process input, process output, critical to quality
Which tool is not part of the analyze phase of Six Sigma project?
Gantt chart
Bar graph
Pie chart
Regression analysis
Gantt chart
Jose is checking his laboratory equipment using test control samples that are designed to produce the same results and used to calibrate the equipment. When he runs 100 samples, he gets two results that are greater than three standard errors of the mean. These results are called
Special variation
The primary goal of Lean is to
eliminate waste
Tiffany is the day shift supervisor in the imaging department. She has redesigned the patient intake system so that patients are asked to provide their name and birth date only once. The old patient system asked for this information three times. What kind of waste did Tiffany reduce.
Overprocessing
Tiffany wants to continue to make improvements in the imaging department and organize a kaizen event. What will be her first step?
Specify value to the patient
Tiffany decides she can improve operations in her department by sorting, labeling, and cleaning the storage area. Which lean tool is she using?
5S
Tiffany works with radiologists in her department to develop a protocol to sterilize each instrument used in a procedure in exactly the same manner. Which lean tool is she using
Standard work
Tiffany institutes a new system taht indicates the status of the CT scanning suite with a series of lights. Green= available and so on. Which lean toold is she using?
Andon
Tiffany worked with radiologists to develop a new system to improve the equipment utilization. In this new system, the instruments needed for an interventional procedure are organized outside of the interventional suite prior to the procedure. Which lean tool is she using?
SMED
The radiology technologists in Tiffany's department specialize in a specific class of procedures. To improve the flow of patients in the department, she has instituted a series of in service educational classes to improve the ability of all her staff to do all procedures. Which lean tool is she using?
Heijunka (load balancing)
Which of the following is not true about Lean and Six Sigma
Require the use of special software
Simulation is used to
develop a model of the real world to gain a better understanding of the system being studied
What is the last step in developing a simulation model?
Building the computer model
A monte carlo simulation model is used to
obtain a distribution of possible outcomes of a system
The time a patient spend in a queue at a clinic's customer service desk depends on
the arrival rate of all patients
What changes can be made to decrease the wait time in a queue
Decrease arrival rate and increase service rate
The term entity is used in discrete event simulation to describe
an object that flows through the system
The term state is used in discrete event simulations to describe
variables that describe the system at a point in time
Discrete event simulation can be used to
model patient flow through an emergency department
Customer arrivals at a dry cleaning service occur randomly throughout the day, the distribution that is usually used to model the interval between arrivals is
Poisson distribution
The goal of queuing analysis is to minimize
sum of customers waiting costs and capacity costs
Cost cutting mistakes
1. Cutting support staff
2. Underinvesting in space and equipment
3. Focusing narrowly on procurement prices
4. Maximizing patient throughput
5. Failing to benchmark or standardize
Myths regarding healthcare
1. Charges are surrogate to provider costs
2. Healthcare overhead is too complex to allocate accurately
3. Most healthcare costs are fixed
5 Catalysts which can spur value based comp.
1. Stop rewarding volume
2. Standardize care to pay for value
3. Make data on outcomes transparent
4. Put patients at center of care
5. Give choice to providers and patients
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